Sinusitis during pregnancy: how to treat it

Features of the disease

Depending on the severity of sinusitis during pregnancy, the disease comes in two forms:

• Acute frontal sinusitis. In this form, the disease is a complication of rhinitis after an infectious disease. Signs of acute sinusitis during pregnancy manifest themselves in the form of fever, chills, severe pain in the frontal part of the head, which intensifies when the body is tilted down. Mucus from the nasal cavity can range from light in color and liquid consistency to green, thick snot.
• The chronic form of sinusitis during pregnancy is characterized by a disease duration of a month or more. The symptoms of chronic sinusitis are less pronounced compared to the acute form, but cause no less problems for the woman: the nose is constantly stuffy, the head periodically hurts, appetite decreases, and the general condition of the body worsens.

Each person has four types of sinuses in the nasal cavity, and depending on which of them the inflammatory process occurs, there are several types of sinusitis during pregnancy.

Types of sinusitis:

1. Sinusitis. With sinusitis, the maxillary openings become inflamed. When inflamed, the mucous membrane swells significantly, preventing the outflow of secretions from the nose. Snot accumulates in the sinuses, pressure on the bone tissue increases, and the patient begins to experience severe headaches.
2. Frontit. In this case, the patient's lesion is located in the frontal sinuses of the nasal cavity. The danger of frontal sinusitis lies in the fact that the inflammatory process is in close proximity to the lining of the brain.
3. Ethmoiditis. With ethmoidal sinusitis, the ethmoidal labyrinth of the nasal cavity is involved in the inflammatory process.
4. Sphenoiditis. Muconasal secretions are collected in a wedge-shaped foramen located deep at the base of the skull.

During pregnancy, sinusitis can vary in severity.

Difficulty of the disease:

• Light form. In this case, the expectant mother is not bothered by high fever and headache. Copious nasal discharge is most often clear and liquid. To treat sinusitis during mild pregnancy, nasal rinsing and traditional medicine recipes are usually sufficient.
• Medium shape. In this case, the body temperature remains at 37-37.5 degrees, the woman is bothered by a stuffy nose and mild headaches.
• Severe form. Severe sinusitis cannot be treated without medication. Severe sinusitis during pregnancy is equally dangerous for the fetus and the expectant mother. Purulent sinusitis is accompanied by high fever, severe pain in the forehead, and chills.

Without timely treatment, sinusitis can lead to a number of serious complications; during pregnancy, the disease must be approached with special responsibility.

What is sinusitis

Sinusitis is an inflammatory process of the mucous membrane that occurs in the paranasal sinuses. Most often, sinusitis affects the largest maxillary (maxillary) sinuses. In this case, the disease is called sinusitis, this is a special case of sinusitis. As a rule, inflammation spreads symmetrically, in both directions at once. If all the other nasal sinuses are affected (and there are only six of them), then they talk about pansinusitis.

In practice, doctors use the term “sinusitis” when the inflammatory process has spread to several sinuses at once. Depending on the location of the disease, the woman experiences the following symptoms:

• with inflammation of the frontal sinuses - acute attacks of headache in the forehead area, pain in the eyes, possibly a sharp increase in temperature and swelling of the eyelids;
• inflammatory process in the ethmoid labyrinth - constant headache in the area of ​​the bridge of the nose, pain behind the eyeball, nasal discharge, difficulty breathing, sudden increase in temperature, sometimes sore throat and discharge of purulent mucus in the morning;
• with inflammation of the sphenoid sinuses (the rarest type of sinusitis) - pain in the back of the head and crown, possible inflammation of the maxillary sinuses.

A normal runny nose goes away in about a week. If the mucus discharge continues longer, and even becomes purulent with an unpleasant odor, accompanied by pain and fever, urgent consultation with a specialist is needed. Perhaps these are manifestations of sinusitis. If the disease lasts longer than three months, there is reason to talk about chronic sinusitis.

Types of sinusitis

There is a division of sinusitis according to the types of pathogens:

• viral sinusitis is the result of infectious and viral diseases;
• purulent sinusitis - the work of bacteria that form pus (they often accompany respiratory diseases);
• fungal sinusitis - an attack of a fungus as a result of decreased immunity (often observed with long-term treatment with antibiotics);
• odontogenic sinusitis – a complication of caries;
• Allergic sinusitis occurs when you have a runny nose caused by allergies.

According to the degree of severity, they are distinguished:

• acute sinusitis lasts up to three weeks, without accumulation of pus;
• the chronic form lasts up to several months, mucus accumulates in the sinuses, then pus.

Sinusitis, no matter what it is caused by, is an infectious disease. It is transmitted from person to person through direct contact. The risk group includes people with reduced immunity. Therefore, sinusitis during pregnancy is a fairly common occurrence. After all, it is impossible to completely isolate the expectant mother from communicating with other people and visiting public places (transport, shops, clinics, etc.).

Read: what is prothrombin and what is its role during pregnancy.

We advise you to read why pregnant women should not use Sanorin spray for a runny nose.

Symptoms and causes

The first stage of sinusitis can easily be confused with a common cold - nasal discharge, difficulty breathing. That is why doctors warn expectant mothers: during pregnancy, it is important to recognize the beginning of the disease and take measures to eliminate it.

The more advanced sinusitis is, the more seriously you have to take medications, including antibiotics.

Symptoms of sinusitis during pregnancy:

1. Nasal congestion for more than two weeks;
2. Copious discharge from the nasal cavity;
3. Pain in the bridge of the nose and forehead;
4. Loss of ability to smell;
5. “bursting” pain in the area of ​​the nasal septum;
6. Cough at night due to mucus running down the nasopharynx;
7. When a pregnant woman sneezes or coughs, she experiences pain in the ears.

If two or more symptoms are detected, a woman should seek medical help.

Sinusitis cannot occur on its own; certain factors must contribute to this.

Causes of sinusitis during pregnancy:

• Complication of a viral disease;
• Advanced rhinitis;
• Anatomical features of the structure of the nasal septum;
• Diseases in the oral cavity;
• Adenoids;
• Various neoplasms in the nasal cavity;
• Allergic reaction to internal or external irritants;
• Reduced immunity.

Why is sinusitis dangerous during pregnancy?

During pregnancy, any disease can have a negative impact on the development of the fetus. The risk of contracting a cold in an expectant mother increases due to weakened immunity, and the choice of treatment methods is extremely limited. Most medications are undesirable for use during pregnancy, and folk remedies are not always effective.

The danger of sinusitis for a pregnant woman lies in a number of complications: meningitis, otitis, inflammation of the trigeminal nerve, sepsis.

The bacterial flora accumulated in the mucus is carried by the bloodstream throughout the body, and the consequences can be very diverse: from inflammation of the renal pelvis to the development of myocarditis. Chronic sinusitis can cause placental insufficiency, leading to premature birth.

Sinusitis poses a particular danger to the unborn baby. Difficulty breathing of the expectant mother can lead to oxygen starvation of the fetus. Hypoxia, especially in the 2nd trimester, delays the growth and development of the child. Babies who have had an intrauterine bacterial infection are more likely to suffer from neurological diseases.

Causes of sinusitis during pregnancy

There are several causes of the disease:

1. Neglect of acute viral infection. The entry of viral microorganisms into the mucous membrane can provoke an inflammatory process and the development of sinusitis.
2. Changes in the body during pregnancy. A woman may not feel well at first: the symptoms are similar to a cold. This is a normal reaction of the body to pregnancy. The occurrence of rhinitis in this case may be a consequence of the influence of hormones. Its manifestation can provoke sinusitis.

Diagnostics

During pregnancy, a woman cannot use all methods of diagnosing ENT organs. X-rays are extremely undesirable for an expectant mother due to the negative impact of X-rays on the unborn baby. Therefore, doctors use safer diagnostic methods.

Diagnostic methods:

• Rhinoscopy. This is the safest and most accessible way to detect sinusitis in a pregnant woman. Using a special device, the nasal mucosa is examined, the degree of its swelling, and possible polyps and a deviated nasal septum are identified.
• Laboratory study of muconasal secretions from the nose.
• A general blood test will show the presence or absence of an inflammatory process in the body.
• Ultrasound examination. Diagnostics using an ultrasound machine will allow you to find out how widespread the inflammation is and see the accumulation of mucus in a particular sinus.

Only after the diagnosis is carried out, the woman is prescribed the necessary treatment.

Diagnosis of sinusitis during pregnancy

According to statistics, sinusitis occurs several times more often in pregnant women. Doctors associate this phenomenon with a natural decrease in the body's defenses in combination with hormonal changes.

In most cases, pathology develops in the second or third trimester. In 1 – much less often.

There are several ways to diagnose the disease:

1. External examination and palpation. Performed by an otolaryngologist.
2. Diaphanoscopy – transillumination of the maxillary and frontal sinuses.
3. Using a thermal imager to confirm or refute a diagnosis;
4. Ultrasound examination. Of the listed methods, ultrasound is more informative, because it allows you to accurately determine the accumulation of exudate in the cavities and their anatomical structure.

Diagnostic methods such as radiography and computed tomography are not used during pregnancy due to possible negative effects on the fetus.

In addition to hardware diagnostic methods, puncture of the maxillary sinus is used to suction out the purulent contents with a needle.

The method is proven and will not cause harm to either the mother or the child.

The discharged fluid from the nasal passages is sent for bacterial culture and sensitivity to a group of antibiotics is determined to select high-quality and adequate treatment.

Treatment (drugs and folk remedies)

Many pregnant women do not know how to treat sinusitis due to their special situation. Many people are afraid to take any medications, fearing the consequences for the child.

The main goals of treating sinusitis during pregnancy are to normalize breathing and eliminate the source of inflammation in the nasal cavity.

Treatment with drugs

• Antibiotics. For ordinary patients, treatment for sinusitis most often involves taking antibiotics. The exception is allergic and viral sinusitis. But during pregnancy, antibacterial agents are contraindicated for the expectant mother and if they are prescribed, then only as a last resort. Antibiotics in the form of drops have a less negative effect on the fetus: Polydexa, Bioparox, Isofra.
• Vasoconstrictor drops are also prescribed extremely rarely. They allow you to temporarily relieve nasal congestion and normalize the respiratory process.
• Nasal rinsing. You can remove accumulated mucus at home or in a hospital. Chamomile decoction and saline solution wash out pathogenic microorganisms from the mucous membrane and promote a speedy recovery.
• Puncture. A sinus puncture is done if drug treatment is ineffective. The surgical intervention is performed under local anesthesia; during the procedure, purulent mucus is removed from the cavity and the sinus is treated with an antiseptic solution.

Traditional methods of treatment

When treating sinusitis during pregnancy, it is worth remembering that traditional medicine is recommended as an auxiliary treatment in complex therapy. The most popular traditional medicine recipes are still used today.

Traditional recipes:

• Onion juice. To prepare it, you need to take a medium-sized onion, grate it and squeeze out the juice. The resulting liquid should be diluted with boiled water and instilled into each nostril three times a day.
• Steam inhalations. At normal body temperature, sinusitis during pregnancy can be cured using the old proven method. Boil the potatoes, drain the water, and stand over the pan for a while. It is better to cover yourself with a towel or blanket.
• Rinse the nose with chamomile decoction or saline solution.

Treatment of sinusitis in pregnant women

Sinusitis during pregnancy is not an easy task for an ENT doctor, because the most effective treatment is required with minimal medication. We list the main groups of drugs for the treatment of inflammatory processes in the sinuses:

1. Vasoconstrictor drops - Naphthyzin, Naphazoline, Xylometazoline and others. These drops promote spasm of the local vessels of the nose and sinuses, reducing the phenomena of edema and exudation.
2. Antiallergic drugs - Suprastin, Cetrin and others. These agents suppress the mechanisms of edema and exudation.
3. Anti-inflammatory drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) - Paracetamol and Ibuprofen help relieve pain, reduce fever and reduce inflammation.
4. Antibacterial drugs are necessarily indicated for purulent sinusitis. At the stage of serous and catarrhal inflammation, their use, especially in expectant mothers, is not always justified. In some cases, you can use a wait-and-see approach for one or two days, of course under the strict supervision of a doctor.
5. As a rule, various methods of physiotherapeutic treatment are not indicated for pregnant women. In rare cases, in the initial stages of sinusitis, ultrasound treatment and electrophoresis with various medicinal substances are prescribed.

At the stages of serous and catarrhal sinusitis, with the permission of a doctor, you can use various traditional medicines:

• Rinsing the nose and sinuses with saline and antiseptic solutions. These procedures help thin out thick mucus, mechanically wash away bacteria, moisturize the mucous membranes and relieve swelling.
• Inhalation of saline solutions is allowed only with the help of special inhalers and nebulizers. Hot steam inhalations are very dangerous to use at the slightest suspicion of a purulent process. They can contribute to the breakthrough of pus from the sinus into the surrounding tissue.
• Instillation of oil solutions with essential oils, garlic and onion juice, propolis extract and other local antiseptics into the nose.

Sinusitis during pregnancy: prevention

The best prevention of sinusitis during pregnancy is timely treatment of rhinitis. You can protect yourself and your unborn baby from illness by following simple rules.

Prevention measures:

• Limiting contact with infectious patients;
• Nasal hygiene after visiting public places;
• Strengthening immunity;
• Daily walks in the fresh air;
• Proper nutrition.

Taking your health seriously will make it easy to endure pregnancy and avoid many diseases. Sinusitis with timely and competent treatment goes away without complications in 10-14 days.

What nasal spray is possible during pregnancy?

During pregnancy, any drops for treatment are not suitable. The doctor decides how to treat sinusitis during pregnancy. No one else's advice can be implemented.

Instructions for using drops are extremely important. Increasing the frequency of instillations or increasing the single dose is fraught with negative consequences, since the effects of the drug were tested precisely at the indicated dosage.

Drops based on a salt solution are considered the safest during pregnancy. The medicine is sold in any pharmacy. The most famous are Aquamaris and Salin.